Provider Demographics
NPI:1548015753
Name:HIMMELSTEIN, PHILIP (BPHIL)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:
Last Name:HIMMELSTEIN
Suffix:
Gender:M
Credentials:BPHIL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 E WYOMISSING BLVD APT 25B
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19611-2117
Mailing Address - Country:US
Mailing Address - Phone:484-889-1038
Mailing Address - Fax:
Practice Address - Street 1:313 W LIBERTY ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-2798
Practice Address - Country:US
Practice Address - Phone:717-394-3994
Practice Address - Fax:717-394-0124
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health